Anticoagulation versus antiplatelet therapy after percutaneous left atrial appendage closure—subanalysis from the multicenter LAARGE registry

摘要

Abstract Purpose Data regarding post-procedural antithrombotic therapy following percutaneous left atrial appendage (LAA) in real-world populations using various occluder systems is limited. In the present analysis, anticoagulation (AC) was compared against antiplatelet therapy (APT) using data from the real-world multi-center LAARGE study.Methods Patients following LAA closure enrolled in the LAARGE study were assigned to two groups depending on initial post-implantation antithrombotic regime consisting of either AC or APT. Selection of antithrombotic medication was at the discretion of the treating center and/or physician.Results From July 2014 until January 2016, a total of 627 patients at 38 centers were included. A total of 75 patients (12) received AC and 552 patients (88) received APT, respectively. No significant differences were found between the groups regarding the composite of death, stroke and systemic embolism 1?year after LAA closure (Kaplan–Meier estimated rate 9.4 for AC vs. 12.8 for APT; p log rank?=?0.45). With respect to bleeding events also, no differences were observed 1?year after the procedure (major bleeding 4.0 vs. 2.0, p?=?0.23; moderate bleeding 4.0 vs. 4.9, p?=?1.00; any bleeding 8.0 vs. 6.9, p?=?0.73).Conclusions Postprocedural antithrombotic treatment with AC and APT showed comparable results regarding the composite of death, stroke, and systemic embolism as well as regarding bleeding complications after LAA closure in a real-world all-comers population.